Complete Health Indicator Report of Diabetes Prevalence

Definition

Percentage of Utah adults (18+) diagnosed with diabetes.

Numerator

Number of Utah adults who reported being told by a health care professional that they have diabetes (excludes women who were told they had diabetes only during pregnancy or those who reported they had "borderline" or prediabetes).

Denominator

Utah adults 18 and over.

Data Interpretation Issues

The Behavioral Risk Factor Surveillance System (BRFSS) is the primary source for estimating diabetes prevalence for Utah. The BRFSS is a telephone survey (with interviews using both landline and cell phones) that includes only adults 18 and over.

Why Is This Important?

More than 150,000 Utahns have been diagnosed with diabetes. Diabetes is a disease that can have devastating consequences. It is the leading cause of non-traumatic lower-extremity amputation and renal failure. It is also the leading cause of blindness among adults younger than 75. It is one of the leading causes of heart disease.
Diabetes places an enormous burden on health care resources, approximately $245 billion is spent annually [in direct medical costs ($176 billion) and in indirect costs ($69 billion) such as disability, work loss, and premature death]. (See [https://www.ncbi.nlm.nih.gov/pubmed/23468086 Economic costs of diabetes in the U.S. in 2012]). In Utah, more than a billion dollars each year are spent on direct and indirect costs of diabetes.
Currently, about 80 million Americans aged 20 and older have pre-diabetes, a condition that puts them at high risk for developing diabetes. For many individuals, taking small steps, such as losing 5-7 percent of their weight or increasing physical activity, can help them delay or prevent developing diabetes.

Healthy People Objective D-1:

Reduce the annual number of new cases of diagnosed diabetes in the populationU.S. Target: 7.2 new cases per 1,000 population aged 18 to 84 yearsState Target: 7.2 new cases per 1,000 population aged 18 to 84 years

Other Objectives

Healthy People 2020 (HP 2020) emphasizes reducing the incidence of diabetes. HP 2020 Objective D-1 is "Reduce the annual number of new cases of diagnosed diabetes in the population."

How Are We Doing?

The rising prevalence of diabetes in Utah appears to slowing. However, many Utah adults are overweight or obese, and/or lead sedentary lifestyles, adding to the number of people at risk for developing diabetes.
A large number of individuals have pre-diabetes. Pre-diabetes is a condition in which blood sugar rates are elevated but not yet high enough to reach the clinical threshold of a diabetes diagnosis. An estimated 86 million Americans age 20 and older have pre-diabetes. Unless those individuals take steps to reduce their risk of diabetes, such as increasing physical activity, eating a more nutritious diet, or losing weight, the majority will have diabetes within 10 years.

How Do We Compare With the U.S.?

According to the 2017 Behavioral Risk Factor Surveillance System (BRFSS), Utah adults have an age-adjusted rate of 7.5% of diagnosed with diabetes, compared to the U.S. age-adjusted rate of 9.9%.
(Note: An age-adjusted rate is an artificial rate that "adjusts" for differences in age distributions between populations).

What Is Being Done?

The Healthy Living through Environment, Policy, and Improved Clinical Care (EPICC) Program encourages people with diabetes to enroll in a diabetes self-management education class. These classes have been shown to help individuals develop the skills they need to manage their diabetes and are usually taught by dietitians, nurses, or pharmacists, who may also hold the status of Certified Diabetes Educator (CDE). CDEs have considerable expertise in diabetes management and understand what the individual with diabetes is going through.
The Utah Arthritis Program supports Chronic Disease Self-Management Programs and Diabetes Self-Management Programs throughout the state. (This program is also called the Living Well with Chronic Conditions Program.) This six-week program is available throughout the state at no cost and taught by community members. Information is available from Nichole Shepard, 801-538-6259, nshepard@utah.gov. More information is available at [http://livingwell.utah.gov/ livingwell.utah.gov].

Evidence-based Practices

Diabetes Self-Management Classes have been shown to improve blood sugar control among participants. In Utah, programs are available that are recognized by the American Diabetes Association or certified by the American Association of Diabetes Educators. Information on classes in Utah is available at [http://livingwell.utah.gov/ livingwell.utah.gov].

Available Services

The American Diabetes Association (ADA) is an excellent resource for all types of information on diabetes. Call 1-800-DIABETES or visit the website at [http://www.diabetes.org].
The National Diabetes Education Program ([https://www.niddk.nih.gov/health-information/communication-programs/ndep]) has resources for diabetes management for professionals, businesses, and patients. Most materials are available upon request at no charge.
The Utah Department of Health has a Health Resource hotline: 1-888-222-2542. Please call this number for information about self-management programs in Utah.
The Healthy Living through Environment, Policy and Improved Clinical Care (EPICC) website provides information of diabetes self-management classes. For information, please visit
[http://www.choosehealth.utah.gov/your-health/lifestyle-change/dsme.php].
Association of Diabetes Educators [[br]]
[http://www.diabeteseducator.org][[br]]
800-338-3633
American Heart Association[[br]]
1937 S. 300 W. #120[[br]]
Salt Lake City, UT 84115[[br]]
(801) 484-3838 or[[br]]
1-800-242-8721[[br]]
[http://www.heart.org]

Health Program Information

The Utah Department of Health Resource Line can provide information about enrolling in diabetes self-management classes. Call 1-888-222-2542 for more information.

Related Indicators

Relevant Population Characteristics

Anyone can develop diabetes, but the risk for developing type 2 diabetes is greater for those who are older, overweight or obese, physically inactive, and/or a member of a minority racial or ethnic group. As the Utah population ages, and as the proportion of high-risk minority ethnic and racial groups in the population increases, a greater percentage of Utahns will be at risk for developing diabetes.
There is considerable variation in prevalence by race and ethnicity. In the U.S., 7.4 percent of non-Hispanic White persons aged 18 or older have diabetes (age-adjusted prevalence). Members of the American Indian/Alaskan Native population are more than twice as likely to have diabetes as non-Hispanic White persons. About 15 percent (15.1%) of people in this group have been diagnosed. High prevalence is also seen in the non-Hispanic Black population, where the percentage diagnosed is 12.7 percent among adults aged 18 and over 12.1 percent of Hispanics aged 18 and older have diagnosed diabetes. Among non-Hispanic Asians aged 18 and older the age-adjusted rate of diagnosed diabetes is 8.0. (See ''[https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf National Diabetes Statistics Report, 2017]'').

Health Care System Factors

Screening for diabetes is generally recommended for people aged 45 and over, although those with a high risk of developing diabetes (e.g., overweight, member of minority racial or ethnic group) may wish to consider screening by age 30, or even earlier.
Testing for diabetes is generally covered by insurance. For those without insurance, the American Diabetes Association may be contacted about the availability of low-cost or free screening (801-363-3024).
In 2012, the estimated total cost for diabetes in the U.S. was $245 billion. Even undiagnosed diabetes can burden the health care system. Undiagnosed diabetes costs the nation about $18 billion a year. Pre-diabetes is estimated to cost $25 billion (See [https://www.ncbi.nlm.nih.gov/pubmed/23468086 Economic costs of diabetes in the U.S. in 2012]).

Risk Factors

Being overweight or obese is a major risk factor for developing diabetes. The risk of developing diabetes can be substantially reduced through weight loss and regular physical activity. The Diabetes Primary Prevention Study (DPP) showed that weight loss and participation in regular physical activity can significantly decrease the risk. The DPP clinical trial included over 3,000 people who had impaired fasting glucose and were at an increased risk for developing diabetes. Participants who engaged in moderately intense physical activity for 30 minutes per day and lost 5 to 7 percent of their body weight decreased their risk of diabetes dramatically. This behavioral activity was effective for all participants in the study, regardless of age or ethnic group (see [http://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp/Pages/default.aspx]). Some risk factors cannot be modified, such as older age or membership in a minority racial or ethnic group. Nevertheless, risk can be substantially reduced through adhering to a nutritious diet and participating in regular physical activity.

Related Risk Factors Indicators:

Health Status Outcomes

Diabetes can have serious consequences. It is the leading cause of non-traumatic lower extremity amputations, and is also the leading cause of blindness among working-age adults. It is a major risk factor for cardiovascular disease and end-stage renal disease.

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]][[br]]
Rates are age-adjusted using 8 age groups.
Beginning in 2011, U.S. BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. Utah changed to the new methodology in 2009. Utah rates using both old and new methodology are shown for 2009 and 2010. This new methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]]
[[br]] This graph demonstrates the difference in prevalence using old and new methodologies. Beginning in 2011, U.S. BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. Utah changed to the new methodology in 2009. Utah rates using both old and new methodology are shown for 2009 and 2010. The new methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Adults With Diabetes by Local Health District, Utah, 2016-2017

Data for the local health districts (LHDs) used two years of combined data (2016 and 2017) so that reliable estimates for LHDs could be obtained. Summit County Local Health District had a lower rate than the state. Tooele County and TriCounty Local Health Districts had rates that were higher than the state.
The overall rate for the state was 7.7% with two years of data combined (2016-2017).

Local Health District

Age-adjusted Percentage of Adults

Lower Limit

Upper Limit

Record Count: 14

Bear River

8.1%

6.4%

10.1%

Central

7.4%

6.0%

9.2%

Davis County

8.4%

7.2%

9.8%

Salt Lake County

7.2%

6.5%

8.0%

San Juan

9.1%

6.2%

13.2%

Southeast

9.1%

7.2%

11.4%

Southwest

8.3%

6.9%

10.0%

Summit

4.2%

2.5%

7.0%

Tooele

13.5%

10.8%

16.8%

TriCounty

10.5%

8.7%

12.5%

Utah County

7.3%

6.3%

8.4%

Wasatch

4.9%

3.0%

8.0%

Weber-Morgan

8.0%

6.8%

9.5%

State of Utah

7.7%

7.2%

8.1%

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]][[br]]Age-adjusted to U.S. 2000 standard population.

Data Source

Adults With Diabetes by Utah Small Area, 2013-2017

Five years of data were combined to improve reliability of the estimates. However, some estimates still did not meet UDOH standards for reliability and should be interpreted with caution. Those particular estimates are indicated in the data table.
Several Utah Small Areas had rates statistically significantly higher than the state rate: San Juan (Other), Salt Lake City (Glendale) V2, West Valley (Center), South Salt Lake, West Valley (West) V2, Tooele County (Other), Magna, Kearns V2, Daggett and Uintah County, Roy/Hooper, West Valley (East) V2, Tooele Valley, and Layton/South Weber.
Small areas with statistically significantly lower rates than the state rate were: Park City, Salem City, Alpine, Salt Lake City (Foothill/East Bench), Salt Lake City (Southeast Liberty), Weber County (East), Millcreek (East), Ivins/Santa Clara, Draper, Sandy (Northeast), Sandy (Southeast), Farmington, North Logan, and Wasatch County.
These rates are based on BRFSS data collected through both landline and cell phones and use an improved weighting methodology. For more information about the new methodology, see [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Utah Small Areas

Age-adjusted Percentage of Adults

Lower Limit

Upper Limit

Note

Record Count: 130

Brigham City

9.4%

7.0%

12.4%

Box Elder (Other) V2

10.2%

6.7%

15.1%

Tremonton

8.9%

6.3%

12.4%

Logan V2

7.0%

5.4%

9.0%

North Logan

5.2%

3.5%

7.6%

Cache (Other)/Rich V2

7.9%

5.6%

11.0%

Hyrum

9.7%

4.4%

19.7%

Estimate may be unreliable.

Smithfield

6.5%

3.7%

11.1%

Ben Lomond

9.1%

7.5%

11.1%

Weber County (East)

3.9%

2.8%

5.4%

Morgan County

4.6%

2.3%

8.7%

Estimate may be unreliable.

Ogden (Downtown)

9.9%

7.6%

12.9%

South Ogden

7.8%

6.0%

10.2%

Roy/Hooper

10.5%

8.6%

12.9%

Riverdale

7.8%

5.8%

10.6%

Clearfield Area/Hooper

9.6%

7.7%

11.9%

Layton/South Weber

10.1%

8.4%

12.0%

Kaysville/Fruit Heights

6.5%

4.9%

8.7%

Syracuse

7.0%

4.8%

10.2%

Centerville

5.6%

3.7%

8.5%

Farmington

4.8%

3.1%

7.5%

North Salt Lake

5.8%

3.6%

9.4%

Woods Cross/West Bountiful

8.5%

5.5%

13.0%

Bountiful

6.4%

4.8%

8.5%

SLC (Rose Park)

8.9%

6.1%

12.9%

SLC (Avenues)

5.4%

3.4%

8.7%

SLC (Foothill/East Bench)

3.2%

1.9%

5.4%

Magna

11.5%

8.8%

15.0%

SLC (Glendale)

15.2%

11.6%

19.8%

West Valley (Center)

13.2%

10.6%

16.3%

West Valley (West) V2

12.6%

9.3%

16.8%

West Valley (East) V2

10.4%

8.1%

13.3%

SLC (Downtown) V2

7.8%

5.2%

11.4%

SLC (Southeast Liberty)

3.6%

2.0%

6.5%

South Salt Lake

12.6%

9.3%

17.0%

SLC (Sugar House)

7.2%

5.3%

9.7%

Millcreek (South)

6.6%

4.3%

9.8%

Millcreek (East)

3.9%

2.5%

6.3%

Holladay V2

5.7%

4.1%

7.7%

Cottonwood

6.3%

4.7%

8.3%

Kearns V2

11.0%

8.3%

14.5%

Taylorsville (E)/Murray (W)

8.4%

6.3%

11.1%

Taylorsville (West)

9.5%

7.5%

11.9%

Murray

6.9%

4.9%

9.6%

Midvale

7.9%

5.6%

11.1%

West Jordan (Northeast) V2

8.0%

5.7%

11.2%

West Jordan (Southeast)

9.6%

7.4%

12.4%

West Jordan (West)/Copperton

8.0%

5.6%

11.3%

South Jordan V2

7.2%

5.7%

9.0%

Daybreak

6.7%

3.3%

13.1%

Estimate may be unreliable.

Sandy (West)

7.4%

5.2%

10.3%

Sandy (Center) V2

8.0%

5.7%

11.1%

Sandy (Northeast)

4.4%

3.1%

6.3%

Sandy (Southeast)

4.7%

3.2%

6.9%

Draper

4.3%

2.9%

6.5%

Riverton/Bluffdale

6.7%

5.0%

8.8%

Herriman

5.3%

3.4%

8.1%

Tooele County (Other)

12.0%

8.6%

16.7%

Tooele Valley

10.1%

8.5%

11.9%

Eagle Mountain/Cedar Valley

9.4%

5.5%

15.4%

Lehi

6.4%

4.5%

9.0%

Saratoga Springs

4.6%

2.4%

8.9%

Estimate may be unreliable.

American Fork

6.2%

4.6%

8.2%

Alpine

2.8%

1.3%

5.8%

Estimate may be unreliable.

Pleasant Grove/Lindon

7.1%

5.5%

9.1%

Orem (North)

7.9%

5.8%

10.7%

Orem (West)

8.1%

6.0%

11.0%

Orem (East)

5.4%

3.5%

8.3%

Provo/BYU

7.9%

5.9%

10.6%

Provo (West City Center)

7.7%

5.3%

11.1%

Provo (East City Center)

8.8%

4.8%

15.9%

Estimate may be unreliable.

Salem City

2.8%

1.3%

5.8%

Estimate may be unreliable.

Spanish Fork

10.1%

7.1%

14.1%

Springville

8.6%

6.4%

11.6%

Mapleton

4.4%

2.4%

8.1%

Estimate may be unreliable.

Utah County (South) V2

8.1%

4.6%

13.8%

Estimate may be unreliable.

Payson

7.0%

4.9%

9.9%

Park City

2.5%

1.2%

5.2%

Estimate may be unreliable.

Summit County (East)

6.4%

4.5%

9.0%

Wasatch County

5.3%

4.1%

6.9%

Daggett and Uintah County

10.6%

8.9%

12.6%

Duchesne County

7.8%

6.2%

9.9%

Nephi/Mona

7.2%

4.9%

10.4%

Delta/Fillmore

6.4%

4.3%

9.3%

Sanpete Valley

7.6%

5.7%

10.1%

Central (Other)

7.4%

5.7%

9.6%

Richfield/Monroe/Salina

7.3%

5.1%

10.3%

Carbon County

8.8%

7.2%

10.8%

Emery County

7.5%

5.8%

9.8%

Grand County

6.7%

4.5%

9.8%

Blanding/Monticello

5.4%

3.5%

8.2%

San Juan County (Other)

19.8%

13.3%

28.5%

St. George

6.8%

5.5%

8.4%

Washington County (Other) V2

6.0%

3.6%

9.9%

Washington City

5.9%

3.8%

9.0%

Hurricane/La Verkin

7.8%

5.5%

10.9%

Ivins/Santa Clara

4.2%

2.3%

7.4%

Estimate may be unreliable.

Cedar City

8.8%

6.6%

11.5%

Southwest LHD (Other)

7.6%

5.7%

10.0%

State of Utah

7.7%

7.5%

8.0%

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]][[br]]Age-adjusted to U.S. 2000 standard population.[[br]]
[[br]]
A description of the Utah Small Areas may be found on the Methodology and Guidelines page: [https://ibis.health.utah.gov/resource/Guidelines.html].

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change.

Data Source

Adults With Diabetes by Education, Utah, 2017

The overall percentage for adults over the age of 25 with diabetes for all education levels was 8.5%. Adults with a college graduate degree had the lowest rate of diabetes, 6.4%.

Education Level

Age-adjusted Percentage of Adults 25+

Lower Limit

Upper Limit

Record Count: 5

Less Than High School

12.2%

9.1%

16.1%

H.S. Grad or G.E.D.

8.6%

7.4%

10.0%

Some Post High School

9.2%

8.1%

10.4%

College Graduate

6.4%

5.7%

7.3%

Total

8.5%

7.8%

9.2%

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]][[br]]Age-adjusted to U.S. 2000 standard population.

Data Source

Adults With Diabetes by Income, Utah, 2017

The age-adjusted diabetes rate for adults with incomes of less than $25,000 (11.8%) was higher than the state rate of 7.5%

Income Category

Age-adjusted Percentage of Adults

Lower Limit

Upper Limit

Record Count: 5

<$25,000

11.8%

9.9%

14.0%

$25,000-$49,999

9.5%

8.0%

11.2%

$50,000-$74,999

6.9%

5.7%

8.4%

$75,000+

5.1%

4.3%

5.9%

Total

7.5%

6.9%

8.1%

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]][[br]]Age-adjusted to U.S. 2000 standard population.

Data Source

Adults With Diabetes by Ethnicity, Utah, 2017

In 2017, the age-adjusted rate for Hispanic adults was 10.8%, compared to 7.1% for non-Hispanic adults.

Hispanic Ethnicity

Age-adjusted Percentage of Adults

Lower Limit

Upper Limit

Record Count: 3

Hispanic

10.8%

8.3%

14.1%

Non-Hispanic

7.1%

6.6%

7.8%

All Utahns

7.5%

6.9%

8.1%

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]][[br]]Rates are age-adjusted and standardized to the U.S. 2000 population.

Data Source

Adults With Diabetes by Race, Utah, 2015-2017

Three years of data were combined to obtain reliable estimates. Prevalence of diabetes is especially high for members of the Pacific Islander and American Indian populations. It is important to note that these rates are age-adjusted, meaning that rates are artificially compared as though the age distribution for all populations were the same.
The estimate shown for this view combines three years of data (2015- 2017).

Race/Ethnicity

Age-adjusted Percentage of Adults

Lower Limit

Upper Limit

Record Count: 7

American Indian, Alaskan Native

15.3%

11.8%

19.6%

Asian

6.1%

3.8%

9.7%

Black, African American

9.2%

5.7%

14.4%

Native Hawaiian, Pacific Islander

16.3%

9.8%

26.0%

White

6.9%

6.6%

7.3%

Other

10.8%

8.9%

12.9%

All Races/Ethnicities

7.3%

7.0%

7.7%

Data Notes

"Don't know" and "Refused" responses were eliminated from the denominator.
In 2016, Utah BRFSS modified its methodology for age adjustment for increased precision. With this change Utah is consistent with both the U.S. and other states using IBIS. Data has been updated from 2011 onward in all chart views to reflect this change. [[br]][[br]]Age-adjusted to U.S. 2000 standard population based on 3 age groups: 18-34, 35-49, and 50+.

Data Source

References and Community Resources

American Diabetes Association[[br]]
[http://www.diabetes.org][[br]]
[[br]]
Diabetes Prevention Program[[br]]
National Diabetes Information Clearinghouse[[br]]
[http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram][[br]]
[[br]]
Division of Diabetes Translation, Centers for Disease Control and Prevention[[br]]
[http://www.cdc.gov/diabetes][[br]]
[[br]]
American Association of Diabetes Educators [[br]]
[http://www.diabeteseducator.org][[br]]
[[br]]
Much of the information for this indicator was taken from the American Diabetes Association site at [http://www.diabetes.org/diabetes-statistics.jsp].
Information on registering for self-management prediabetes and diabetes programs can be found here [http://livingwell.utah.gov/index.php]

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Utah DOH

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